When I couldn’t keep my medication history straight anymore, I found myself heading toward a low point in my depression. I had moved home after graduating from college and, hoping to make my mental health a priority, began the process of finding new providers. I soon discovered that I could not remember the timeline of when I had tried which medications and for how long. In fact, after a certain number of antidepressants, tried and failed, my illness moved from being “depression” to “treatment-resistant depression”. It wasn’t a surprise to me. After years of therapy, numerous antidepressants, seemingly endless suicidal thoughts, and a hospitalization, “treatment-resistant” feels like an accurate label. While comforting to know that there’s a category for depression like mine, the next steps of treatment resistance were daunting.
Almost a year later, when a psychiatrist at the hospital I was in told me that your chances of successful treatment go down with each new medication you try, the seeds of branching out had vigorously sprouted. My psychiatric nurse practitioner had been suggesting IV ketamine infusions for months, but I was reluctant. I had gotten comfortable with antidepressant pills, and I (rightly) felt no shame in using them; they’re a very common treatment for major depressive disorder. Something more involved, like ketamine, forced me to confront the fact that nothing else was working. I needed more help than antidepressants and therapy could give me, an innocent realization that, in my state of self-hatred, dripped with shame and embarrassment. Nevertheless, I was running out of options, and ketamine was beginning to look promising.
I found a small clinic near me and submitted their online forms. In them, I described my symptoms, the medications I was taking, every antidepressant I had tried in the past, and answered numerous other questions about my medical history. The doctor called me within the day, told me that I seemed like a good candidate, let me know that he would be calling my psychiatric nurse practitioner to verify my diagnosis, and we set up my first appointment. The first appointment was scheduled to be a consultation with the doctor, immediately followed by the first ketamine infusion. The whole process started to move frighteningly fast, although in hindsight, this was great. I might have backed out, had I had more time to ruminate on it.
Upon meeting my doctor, I immediately stopped vacillating between going through with ketamine treatments or bailing on it. I was there, my doctor was kind, and my mother desperately wanted me to try it. I had no stamina left, and had decided that if ketamine didn’t work, that was it. I would give up. From that perspective, I had low expectations and could go into the process with a relatively blank slate. All that was left to do was to sit back, close my eyes, and let what happened, happen.
IV ketamine infusions are different for everyone, and they’re different each time I get one. In general, though, the feeling begins with warm dissociation from my body. Time seems to slow down and my limbs feel like they’re floating away from me. I always feel relaxed, and after a few minutes, I start to “see” shapes, colors, and sometimes entire scenes in my mind. Most people listen to instrumental music during their roughly 45-minute infusions, which makes the experience more immersive.
On the day of my first appointment, I had a vague idea of what to expect, but I was not prepared for how hallucinogenic my first ketamine infusion would be. I was always able to come back to the room, but was quickly pulled back into intense internal visions and altered physical sensations. I was expecting something more sedating and less trippy. Sometimes, I felt like I had no physical body, and at other times, I felt incredibly tall and stretched out. While intense, I was never afraid. I knew where I was and who was around me, and I could respond to questions and make statements. Interestingly, the first infusion is often the strangest, and I’ve found that subsequent infusions are much less overwhelming. I now look forward to them, as each one is so unique. I like to try different music each time, which seems to influence what I see and how the ketamine feels. I’m fascinated by the themes and images my infusions contain because I can sometimes draw direct connections to my real life, like when you dream about something you saw the previous day. Sometimes, I remember very little of an infusion, but the experience is always relaxing, and I like to imagine it up there, influencing the biochemical makeup of my brain.
Generally, people receive a series of six infusions within two to three weeks, followed by “booster” infusions at individualized intervals of several weeks. For some people, ketamine improves their symptoms after the very first infusion. I didn’t see much improvement until my fifth. I began to wake up with more motivation, feel more interest in the activities of the day, and started to enjoy a sense of hopefulness—something I’d been missing for a long time. We extended my initial series to eight infusions to try to maximize my improvement before spacing them out. Each additional infusion seemed to solidify the changes to my mood. I marveled at how much better I felt and how much easier it was to function in the world. In the depths of depression, there was nothing that anyone could have said to convince me that ketamine would work for me. I had to try it, have patience with it, and let go of my judgments when it didn’t work right away.
It hasn’t been a completely straight line from beginning to present; the factors of life will always affect depression’s grip, and I don’t expect that it will be easy from here on out. However, once it started to work for me, ketamine pulled me out of depression and suicidality like nothing else did. I wish that I had tried it earlier, but I was held back by my fear and the uncertainty of trying something new. Regardless of how many antidepressants you’ve tried or how long you’ve fought depression, there is always hope. Sometimes, considering other avenues is exactly what it takes to get on the road to recovery.
If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.
Author Bio: Genevieve Brown is an editor and freelance writer in Boulder, Colorado. For fun(?), she writes about her experiences with major depressive disorder and sensory processing disorder on her blog, Love, Your Brain.
Photo by Jen Theodore on Unsplash
The opinions and views expressed in this guest blog do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in this article or linked to herein.
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The Ketamine Infusions sounds like a good option for my son. He has suffered from depression and anxiety for most of his life. He also has some learning issues that lead to his depression. He made it through high school and went to college on a football scholarship. He was a D1 starter as a freshman. The whole time in college he joggled football academics and his depression and anxiety. He moved back in with us and is totally wiped out with this disorder. We have tried meds, therapy. He is sicking fast. Would he be a candidate for Ketemine infusion? we are out of options for him. HE is in bad shape. TKS BOB
My experience was VERY similar to yours. One main difference was that I have also experienced a great deal of anxiety, along w depression. A lifelong battle but in my case, no medication helped long term (only ones that worked short term were for anxiety like benzo’s). I feel like what I suspect “normal” ppl must feel like..a veil has been lifted. And I agree, I had NO idea how psychadelic the Infusions would be! But like you said, I was still aware of my surrounding & stayed relaxed. I would like to add that one time the Dr added diphenhydramine (Benadryl) to the IV. I had a horrible time for about 24 hours after. Turns out Benadryl can cause anxiety.
My son has had depression/anxiety/PTSD, for years. He’s 30 now. I’ve just read about this therapy and he is continually reading to find something, anything to help the depths of his hopelessness. He’s talked lately about suicide. He just read information about ketamine infusions and has made an appt for tomorrow. Do we dare hope this could be helpful?
Cindy,
Thanks for reading the blog and commenting. One of our Resource Specialists will reach out to you in private to offer assistance.
Jay
I’m considering ketamine for my very serious treatment resistant depression but I’m afraid of it.
Linda,
Thank you for reading the blog and commenting. I have asked one of our Resource Specialists to contact you in private to offer guidance in this matter.
There are no fees or charges associated with this service.
Best wishes,
Jay
I would love to try this as my life has been completely halted and crippled by anxiety/depression. I can not even find a legitimate physc doc, but would love to get off these worthless meds. In order to get this done, what requirements would I need to have? I have a neurologist and regular primary doctor that understand my situation, but not sure if they would be who you would need to speak with.
Looking forward to get some help moving forward with this — could you briefly mention cost (on here so most people can see what to expect)? As well if you take insurance for this as well.
Thank you
Jake,
The cost of Ketamine treatment will vary a great deal according to where you live and what kind of insurance you carry. I suggest you speak with your neurologist or primary care physician about it and ask them for a referral to a clinic in your area that can provide the treatment.
Thank you for reading the blog and commenting.
Jay
I’m definitely major drug resistant and major depressive disorder my whole life. With a lot of anixity mixed in. Im disabled. I was crushed by a horse. I hoping it will help with pain also. There has been times I have spent years in bed because of depression. Months in psych hospital. I also cut.
I want to have the Ketamine therapy. My concern is the cost. If my insurance doesn’t cover it I will sell something to pay for it.
Hello, nice article. I have treatment resistant depression and have suffered from it for many years. My main question is this: What are the odds of ketamine infusions working for someone who has tried esketamine (spravato) in a medical study and came away disappointed? I understand they are different drugs, but I don’t know how different. Why should I invest significant funds in ketamine infusions when a similar seeming drug failed to work?
I should mention that I also tried TMS several years ago, as well as many traditional antidepressants over the years, and nothing has worked. Thank you!
I used ketamine nasal spray one puff in one nostril two in the next nostril and then alternate back-and-forth depending on the day and I have to tell you it was great I could spray it in my nose on the way home from the pharmacy that Compounding Pharmacy and without any issues. My husband had Ketamine for an anesthesia and he had a hallucinations it was crazy. I have had none of these I stop taking Ketamine because of all the hoopla and negative feedback I was getting but they just opened a ketamine in Clinic in my little town and I’m going to look into it, it was a wonderful alternative to antidepressants. Thank you.